Tillis, Travon Di Angelo

Tillis, Travon Di Angelo is an individual health care provider with primary practice located at 625 Fair Oaks Ave 300, South Pasadena CA 91030-2630. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Tillis, Travon Di Angelo can be contacted via phone (626) 395-7100.

Contact Information

Primary practice address
625 Fair Oaks Ave 300 South Pasadena CA 91030-2630
Phone: (626) 395-7100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner 225400000X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X ASW104373 California

Profile Details

NPI number 1740407576
LBN Legal business name Tillis, Travon Di Angelo
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2007
Last updated Sep 11th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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